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v12 radiosurgery

Ganesh Narayanasamy, Sotirios Stathakis, Alonso N Gutierrez, Evangelos Pappas, Richard Crownover, John R Floyd, Niko Papanikolaou
BACKGROUND: In this treatment planning study, we compare the plan quality and delivery parameters for the treatment of multiple brain metastases using 2 monoisocentric techniques: the Multiple Metastases Element from Brainlab and the RapidArc volumetric-modulated arc therapy from Varian Medical Systems. METHODS: Eight patients who were treated in our institution for multiple metastases (3-7 lesions) were replanned with Multiple Metastases Element using noncoplanar dynamic conformal arcs...
September 9, 2016: Technology in Cancer Research & Treatment
Juan F Calvo-Ortega, David Delgado, Sandra Moragues, Miquel Pozo, Joan Casals
AIMS: To dosimetrically compare the fixed gantry intensity modulated radiosurgery (IMRS) with dynamic conformal arc radiosurgery (DCARS) for cranial lesions. This study investigates whether IMRS can be an adequate dosimetric alternative to DCARS for cranial stereotactic radiosurgery (SRS). SUBJECTS AND METHODS: Forty-five SRS procedures for solitary brain metastasis (range: 0.44-29.18 cm 3) performed at our institution were selected for this study. Two plans were generated per patient: One IMRS plan using a multileaf collimation (MLC) of 5 mm, and one DCARS plan designed with a 3 mm micro-MLC...
April 2016: Journal of Cancer Research and Therapeutics
Rafael Garcia, Kita Sallabanda, Iciar Santa-Olalla, Jose Luis Lopez Guerra, Lijia Avilés, Morena Sallabanda, Eleonor Rivin, José Samblás
Modern technologies allow the delivery of high radiation doses to intramedullary spinal cord metastases while lowering the dose to the neighboring organs at risk. Whether this dosimetric advantage translates into clinical benefit is not well known. This study evaluates the acute and late toxicity outcomes in a patient treated with robotic radiosurgery for an intramedullary spinal cord metastasis. A 50-year-old woman diagnosed in May 2006 with invasive ductal carcinoma of the right breast T2N3M1 (two liver metastases) received chemotherapy with a complete response...
2016: Curēus
Thierry Gevaert, Femke Steenbeke, Luca Pellegri, Benedikt Engels, Nicolas Christian, Marie-Thérèse Hoornaert, Dirk Verellen, Carine Mitine, Mark De Ridder
PURPOSE: To investigate the feasibility of a novel dedicated treatment planning solution, to automatically target multiple brain metastases with a single isocenter and multiple inversely-optimized dynamic conformal arcs (DCA), and to benchmark it against the well-established multiple isocenter DCA (MIDCA) and volumetric modulated arc therapy (VMAT) approaches. MATERIAL AND METHODS: Ten previously treated patients were randomly selected, each representing a variable number of lesions ranging between 1 to 8...
2016: Radiation Oncology
Tianfang Li, Cihat Ozhasoglu, Steven Burton, John Flickinger, Dwight E Heron, M Saiful Huq
For targets with substantial volume, collimators of relatively large size are usually selected to minimize the treatment time in robotic radiosurgery. Their large penumbrae may adversely affect the dose gradient around the target. In this study, we implement and evaluate an inner-shell planning method to increase the dose gradient and reduce dose to normal tissues. Ten patients previously treated with CyberKnife M6 system were randomly selected with the only criterion being that PTV be larger than 2 cm(3). A new plan was generated for each patient in which the PTV was split into two regions: a 5 mm inner shell and a core, and a 7...
November 8, 2015: Journal of Applied Clinical Medical Physics
Andrew Woerner, John C Roeske, Matthew M Harkenrider, John Fan, Bulent Aydogan, Matthew Koshy, Robert Laureckas, Faisal Vali, Maria Campana, Murat Surucu
PURPOSE: A multi-institutional planning study was performed to evaluate the frequency that current guidelines established by Radiation Therapy Oncology Group (RTOG) protocols and other literature for lung stereotactic body radiotherapy (SBRT) treatments are followed. METHODS: A total of 300 patients receiving lung SBRT treatments in four different institutions were retrospectively reviewed. The treatments were delivered using Linac based SBRT (160 patients) or image guided robotic radiosurgery (140)...
August 2015: Medical Physics
Juan Francisco Calvo-Ortega, Sandra Moragues, Miquel Pozo, David Delgado, Joan Casals
To evaluate the dosimetric effect of placing the isocenter away from the planning target volume (PTV) on intensity-modulated radiosurgery (IMRS) plans to treat brain lesions. A total of 15 patients who received cranial IMRS at our institution were randomly selected. Each patient was treated with an IMRS plan designed with the isocenter located at the target center (plan A). A second off-target isocenter plan (plan B) was generated for each case. In all the plans,100% of the prescription dose covered 99% of the target volume...
2015: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Evan M Thomas, Richard A Popple, Xingen Wu, Grant M Clark, James M Markert, Barton L Guthrie, Yu Yuan, Michael C Dobelbower, Sharon A Spencer, John B Fiveash
BACKGROUND: Volumetric modulated arc therapy (VMAT) has been shown to be feasible for radiosurgical treatment of multiple cranial lesions with a single isocenter. OBJECTIVE: To investigate whether equivalent radiosurgical plan quality and reduced delivery time could be achieved in VMAT for patients with multiple intracranial targets previously treated with Gamma Knife (GK) radiosurgery. METHODS: We identified 28 GK treatments of multiple metastases...
October 2014: Neurosurgery
Jan Hrbacek, Stephanie Lang, Shaun N Graydon, Stephan Klöck, Oliver Riesterer
PURPOSE: To compare contribution and accuracy of delivery for two flattening filter free (FFF) beams of the nominal energy 6 and 10 MV and a 6 MV flattened beam for early stage lung cancer. METHODS: For each of 11 patients with stage I nonsmall cell lung cancer three volumetric modulated arc therapy plans were prepared utilizing a 6 MV flattened photon beam (X6FF) and two nonflattened beams of nominal energy 6 and 10 MV (X6FFF, X10FFF). Optimization constraints were set to produce dose distributions that meet the criteria of the RTOG-0915 protocol...
March 2014: Medical Physics
Terence T Sio, Sunyoung Jang, Sung-Woo Lee, Bruce Curran, Anil P Pyakuryal, Edward S Sternick
The authors compared the relative dosimetric merits of Gamma Knife (GK) and CyberKnife (CK) in 15 patients with 26 brain metastases. All patients were initially treated with the Leksell GK 4C. The same patients were used to generate comparative CK treatment plans. The tissue volume receiving more than 12 Gy (V12), the difference between V12 and tumor volume (V12net), homogeneity index (HI), and gradient indices (GI25, GI50) were calculated. Peripheral dose falloff and three conformity indices were compared...
2014: Journal of Applied Clinical Medical Physics
Karina P Esparza-Moreno, Olivia A García-Garduño, Paola Ballesteros-Zebadúa, José M Lárraga-Gutiérrez, Sergio Moreno-Jiménez, Miguel A Celis-Lopez
Trigeminal neuralgia (TN) is a chronic, episodic facial pain syndrome that can be extremely intense, and it occurs within the regions of the face that are innervated by the three branches of the trigeminal nerve. Stereotactic radiosurgery (SRS) is the least invasive procedure to treat TN. SRS uses narrow photon beams that require high spatial resolution techniques for their measurement. The use of radiographic or radiochromic films for small-field dosimetry is advantageous because high spatial resolution and two-dimensional dose measurements can be performed...
2013: Journal of Applied Clinical Medical Physics
Chuxiong Ding, Timothy D Solberg, Brian Hrycushko, Paul Medin, Louis Whitworth, Robert D Timmerman
PURPOSE: To investigate a multi-staged robotic stereotactic radiosurgery (SRS) delivery technique for the treatment of large cerebral arteriovenous malformations (AVMs). The treatment planning process and strategies to optimize both individual and composite dosimetry are discussed. METHODS: Eleven patients with large (30.7 ± 19.2 cm(3)) AVMs were selected for this study. A fiducial system was designed for fusion of targets between planar angiograms and simulation CT scans...
December 2013: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
I A Cetin, R Ates, J Dhaens, G Storme
BACKGROUND AND PURPOSE: The aim of the study was to validate the use of linac-based radiosurgery in arteriovenous malformation (AVM) patients and to predict complications using an integrated logistic formula (ILF) in comparison with clinical outcomes. PATIENTS AND METHODS: The results of radiosurgery in 92 AVM patients were examined. All patients were treated with linac-based radiosurgery. Of these, 70 patients were followed for 12-45 months (median, 24 months) and were analyzed...
December 2012: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Brett W Cox, Andrew Jackson, Margie Hunt, Mark Bilsky, Yoshiya Yamada
PURPOSE: To report the esophageal toxicity from single-fraction paraspinal stereotactic radiosurgery (SRS) and identify dosimetric and clinical risk factors for toxicity. METHODS AND MATERIALS: A total of 204 spinal metastases abutting the esophagus (182 patients) were treated with high-dose single-fraction SRS during 2003-2010. Toxicity was scored using the National Cancer Institute Common Toxicity Criteria for Adverse Events, version 4.0. Dose-volume histograms were combined to generate a comprehensive atlas of complication incidence that identifies risk factors for toxicity...
August 1, 2012: International Journal of Radiation Oncology, Biology, Physics
Kazuhiro Ohtakara, Shinya Hayashi, Noriyuki Nakayama, Naoyuki Ohe, Hirohito Yano, Toru Iwama, Hiroaki Hoshi
The objective of this study was to investigate the factors that potentially lead to brain radionecrosis (RN) after micromultileaf collimator-based stereotactic radiosurgery (SRS) for brain metastases. We retrospectively evaluated 131 lesions with a minimum follow-up of 6 months, 43.5% of which received prior whole-brain radiotherapy (WBRT). The three-tiered location grade (LG) was defined, as follows, for each target by considering mainly the depth from the brain surface: grade 1 (superficial), involving the region at a depth of ≤5 mm from the brain surface; grade 2 (deep), located at a depth of >5 mm from the brain surface; and grade 3 (central), located in the brainstem, cerebellar peduncle, diencephalon, or basal ganglion...
May 2012: Journal of Neuro-oncology
Ehsan H Balagamwala, John H Suh, Gene H Barnett, Mohammad K Khan, Gennady Neyman, Rong S Cai, Michael A Vogelbaum, Eric Novak, Samuel T Chao
PURPOSE: To investigate the relationship between the conformality index (CIn), heterogeneity index (HIn), and gradient index (GIn) and the development of toxicity in patients treated with Gamma Knife radiosurgery (GKRS) for intracranial meningiomas. METHODS AND MATERIALS: Treatment records of patients treated from 1997 to 2009 with at least 6 months of follow-up were reviewed. The following parameters were collected: CIn, HIn, GIn (ratio of the volume receiving half the prescription isodose to the volume receiving the full prescription isodose), brainstem (BS) maximum dose (MD), BS volume receiving ≥ 12 Gy (V12), optic apparatus (OA) MD, OA V8 Gy, OA V10, number of isocenters, number of isocenters outside target volume, and the occurrence of six toxicities...
August 1, 2012: International Journal of Radiation Oncology, Biology, Physics
Giuseppe Minniti, Enrico Clarke, Gaetano Lanzetta, Mattia Falchetto Osti, Guido Trasimeni, Alessandro Bozzao, Andrea Romano, Riccardo Maurizi Enrici
PURPOSE: to investigate the factors affecting survival and toxicity in patients treated with stereotactic radiosurgery (SRS), with special attention to volumes of brain receiving a specific dose (V10 - V16 Gy) as predictors for brain radionecrosis. PATIENTS AND METHODS: Two hundred six consecutive patients with 310 cerebral metastases less than 3.5 cm were treated with SRS as primary treatment and followed prospectively at University of Rome La Sapienza Sant'Andrea Hospital...
2011: Radiation Oncology
Brian J Blonigen, Ryan D Steinmetz, Linda Levin, Michael A Lamba, Ronald E Warnick, John C Breneman
PURPOSE: To investigate the correlation between volume of brain irradiated by stereotactic radiosurgery (SRS) and the incidence of symptomatic and asymptomatic brain radionecrosis (RN). METHODS AND MATERIALS: A retrospective analysis was performed of patients treated with single-fraction SRS for brain metastases at our institution. Patients with at least 6-month imaging follow-up were included and diagnosed with RN according to a combination of criteria, including appearance on serial imaging and histology...
July 15, 2010: International Journal of Radiation Oncology, Biology, Physics
N Blanchard, V Bernier, R Anxionnat, L Picard, C Marchal, I Buchheit, C Metayer, E Desandes, D Peiffert
PURPOSE: To study prognostic factors of obliteration and risk factors of brain radiation necrosis in order to propose an algorithm for radiosurgery prescription for cerebral arteriovenous malformations (cAVM). MATERIAL AND METHODS: One hundred and seventy-nine patients were analysed. Radiosurgery delivered 6 or 10 MV X-rays by arc therapy in 84% of cases, or by fixed field in 16% of cases using two different micro-multileaf collimators (micro-MLC). Follow-up consisted of screening radiation necrosis by MRI every 6 months, and assessing local control by arteriography every 2 years...
January 2009: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Sabine Levegrün, Holger Hof, Marco Essig, Wolfgang Schlegel, Jürgen Debus
PURPOSE: . To evaluate late radiation effects in the brain after radiosurgery of patients with cerebral arteriovenous malformations (AVMs) and to quantify dose/volume-response relations for radiation-induced changes of brain tissue identified on follow-up neuroimaging. PATIENTS AND METHODS: . Data from 73 AVM patients who had stereotactic Linac radiosurgery at DKFZ (German Cancer Research Center), Heidelberg, Germany, were retrospectively analyzed. The endpoint of radiation-induced changes of brain tissue on follow-up magnetic resonance (MR) neuroimaging (i...
December 2004: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
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